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Transvaginal Aspiration of Ovarian Cysts: Long-Term Follow-up

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Abstract

Background and purpose

Transvaginal aspiration of ovarian cysts has been advocated as a viable alternative to surgery in patients who are high-risk surgical candidates. We describe a retrospective study evaluating the results of transvaginal aspirations of benign ovarian cysts in patients at increased surgical risk, focusing on long-term follow-up for recurrence of the cyst and/or development of malignancy.

Methods

Twenty-four women with ovarian cysts underwent 34 transvaginal drainages between October 1998 and December 2004. All patients were referred following diagnosis of a persistent ovarian cyst with a benign appearance on ultrasound. All patients were unsuitable candidates for surgery (history of previous pelvic surgery, n = 21; high risk for anesthesia, n = 1; and unsuitable for laparoscopy due to obesity, n = 2). Patients with a history of pregnancy, acute abdominal symptoms, or previous gynecologic malignancy were excluded. A 20G × 20 cm Chiba needle was used for transvaginal aspiration using an endocavity probe (Acuson XP, Mountain View, CA, USA; Siemens Sololine, Erlangen, Germany) and intravenous sedoanalgesia. Cysts were aspirated to dryness.

Results

Long-term follow-up of patients was performed and revealed a recurrence rate of 75%. Eighty-three percent of cysts on the left and 42% of those on the right recurred. Nine of 15 (60%) patients with recurrence required further intervention. Two of 9 underwent surgical intervention only, 4 of 9 had repeat transvaginal aspiration(s) performed, and 3 of 9 had a combination of both transvaginal aspiration and surgery. No patient developed ovarian malignancy.

Conclusion

Transvaginal cyst aspiration has many advantages including short hospital stay, rapid recovery, excellent patient tolerance, and a low rate of procedure-related complications. Our study demonstrates that ovarian cyst recurrence following transvaginal drainage is a more significant problem than previously documented, especially if the cyst is on the left side. However, when recurrences do occur, repeat transvaginal aspirations may be considered in the symptomatic patient.

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Authors and Affiliations

  1. Department of Academic Radiology, Beaumont Hospital, Dublin 9, Ireland

    D. Duke, J. Colville, A. Keeling, D. Broe, T. Fotheringham & M.J. Lee

  2. Royal College of Surgeons in Ireland, St. Stephen’s Green, Dublin 2, Ireland

    D. Duke, J. Colville, A. Keeling, D. Broe, T. Fotheringham & M.J. Lee

Authors
  1. D. Duke
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  2. J. Colville
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  3. A. Keeling
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  4. D. Broe
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  5. T. Fotheringham
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  6. M.J. Lee
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Correspondence to M.J. Lee.

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Duke, D., Colville, J., Keeling, A. et al. Transvaginal Aspiration of Ovarian Cysts: Long-Term Follow-up. Cardiovasc Intervent Radiol 29, 401–405 (2006). https://doi.org/10.1007/s00270-005-0167-0

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  • DOI: https://doi.org/10.1007/s00270-005-0167-0

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